Air Force Col. Joseph Brennan, the Ear, Nose, and Throat doctor at the U.S. run Staff Sgt. Heath N. Craig Joint Theater Hospital, demonstrates how the portable hearing test machine works with the help of Air Force Staff Sgt. Lee Adams, an Ear, Nose, and Throat technician.

Air Force Col. Joseph Brennan, the Ear, Nose, and Throat doctor at the U.S. run Staff Sgt. Heath N. Craig Joint Theater Hospital, demonstrates how the portable hearing test machine works with the help of Air Force Staff Sgt. Lee Adams, an Ear, Nose, and Throat technician.

BAGRAM AIRFIELD, Afghanistan -- When gearing up for a mission in Afghanistan, a servicemember wouldn't forget their helmet, gloves, weapon, eye protection or body armor, but what about hearing protection'

According to Air Force Staff Sgt. Lee Adams, an Ear, Nose and Throat technician at Bagram Air Field, more than 50 percent of the patients seen in the ENT walk-in clinics are there for hearing related issues.

"The first question I ask a patient who comes in with a hearing complaint is 'Were you wearing hearing protection''" said Air Force Col. Joseph A. Brennan, the ENT doctor here on Bagram. "Since I arrived here in May, I have not had one service member answer yes to that question."

Deployed servicemembers are exposed to many dangers while in combat zones. According to Brennan, many troops do not use hearing protection while out on missions, because they feel that the hearing protection affects their ability to do their job and complete their missions.

"I was in Iraq in '04 and '05 in Fallujah with the Marines and the Army's 1st Infantry Division, and we just couldn't get folks to wear their hearing protection," said Brennan.

"We understand. It is like the old Army helmets, Soldiers were complaining they couldn't shoot with them. So even though they offered better protection, which as a doctor is what I care about, the fight is most important," he added.

While in Iraq, Brennan saw more than 600 outpatients in an ENT clinic, and hearing loss was the number one diagnosis there, just as it is today in Afghanistan.

When servicemembers are exposed to loud noises such as an Improvised Explosive Devices, -- the number one reason for hearing loss in Iraq and Afghanistan-- they are susceptible to receiving conductive hearing loss, sensory neuro hearing loss or tinnitus.

Conductive hearing loss can usually be fixed surgically and range from damaged ear bones to wax in the external canal of the ear.

Sensory Neuro means the nerve in the inner ear has been damaged. There is no way to surgically fix this; the only treatment is hearing aids.

Tinnitus is another form of hearing damage. It is a ringing or whining inside of a person's ear that can result from damage to the nerve.

There are two forms of tinnitus: objective and subjective. If a person has objective tinnitus, the sound inside the ear can be measured with a device used by ENTs, while a person with subjective tinnitus is the only person who can hear the sound in their ear. It is immeasurable by outside people.

There is no cure for tinnitus. Tinnitus can be "masked" by a device called a Masker. The tiny device is a type of hearing aid that replaces the noise caused by tinnitus with a less annoying, more natural sound inside the ear, according to Brennan.

The most common problem is blown out ear drums, which can heal on its own. A hole in an ear drum is considered a conductive form of hearing loss. This means that sound is not reaching the nerve in the ear that allows people to hear.

"In Iraq in 2004, there was a Soldier who was in two IED blasts. The second explosion really blew out his ear drums, and he could not hear a thing," said Brennan. "The Soldier's sergeant and his fellow Soldiers were on a roof top in a fire fight. The bullets were buzzing by his head. His sergeant had to tackle him to get him out of the line of fire, because the Soldier could not hear his comrades yelling for him to take cover."

According to Brennan, this story is why hearing protection is so important to Soldiers. The hearing impaired Soldier not only puts himself into danger, but also his fellow soldiers.

Even if a person suffers hearing loss in only one ear, they can still be a danger, continues Brennan. Their directionality is impaired, and they will not be able to tell which direction a sound is coming from. This is especially bad for military personnel when if they cannot decipher which direction bullets are coming from.

Since hearing damage affects the safety of military personnel and others around them, troops can be discharged from the military or forced to re-class into different job specialty, away from loud noises that cannot further damage the servicemember's hearing.

Active-duty personnel who have combat related hearing loss will receive hearing aids while on active duty. After they leave the military, the Veteran's Association will provide the servicemember hearing aids for the rest of their life, Brennan said.

With IEDs being the number one problem for Coalition forces in Afghanistan, it is no surprise that IEDs are the number one reason for hearing loss among the military community. Servicemembers need to protect themselves from this very real problem, and new technology is always being developed to help in the fight against hearing loss.

"The best kind of ear plug, the military is actually working on at the Air Force research lab on Wright- Patterson Air Force base in Ohio, is called active hearing protection," Brennan said. "A person would wear this device on the inside or outside of their ear. For instance, if you were walking through the woods this ear plug would amplify the sounds around you, but the moment the noise level reached a harmful level the ear plug would protect your ear and eliminate the sound, essentially plugging your ears."

This new form of ear plug is ideal because it increases a person's awareness, but also protects the servicemember's ears. Normal ear plugs are called passive hearing protection. They have the same effect as plugging your ears with your fingers, according to Brennan.

Hearing protection is just as important to a servicemember's safety as is his body armor and helmet. The repercussions for a troop who suffers severe hearing loss could end their career as quickly as other combat related injuries. Military personnel should listen to their leadership about wearing proper hearing protection...while they can still hear their warnings.